This invention relates to the practice of psychotherapy in an environment whereby insurance companies and HMOs govern, by their payment rules, how patients are cared for. More particularly, this invention deals with a method for automating the gathering of patient information as well as automating documentation, Treatment Plans, and reports required by insurance companies.
In the United States, especially in the last eight years with the explosive growth of managed care and increasingly where Medicare or Medicaid pays for treatment, the administration of psychotherapy is driven by insurance companies. These companies seek to minimize the cost of treatment and demand rigorous documentation by the care provider. As a result, care providers are forced to spend less time with patients and to spend more time generating documentation. As might be expected, patient care has deteriorated with caregivers increasing spending more time, money and energy interacting with managed care companies seeking approval and providing justification for initial concurrent and ongoing treatment.
Despite time constraints, the caregiver is expected to interact with a patient, and to make and record observations about patients and their behavior. At some later point, the caregiver must define patient Treatment Plans and generate detailed patient progress reports, typically two pages in length. Treatment Plans and status reports are derived from observations made while the caregiver sees patients. It is not uncommon for a caregiver to see thirty to fifty patients per day.
Under these trying circumstances, the pressure on caregivers is enormous. The caregivers are attempting to provide a high level of individualized care to a multitude of patients in a very short period of time, yet are expected to provide extensive documentation of the progress of each patient. Given the circumstances, patients tend to blur together making it difficult for the caregiver to remember enough detail about each patient to adequately report progress and to devise effective Treatment Plans.
All three parties, the patient, the caregiver, and the insurance company are badly served by the above situation. The patient receives less individualized care than he or she requires. The caregiver is under pressure to produce results and documentation in an inadequate period of time. The insurance agency receives minimal, often generic documentation. What is needed is a method for easing the caregiver""s documentation burden so that he or she might be able to spend more quality, focused, unencumbered time with patients. The insurance company demands for rigorous documentation will not change, thus caregivers must be provided with a method that will enable them to produce the extensive documentation required in less time.
It is therefore an object of the invention to provide psychotherapy caregivers with an apparatus that will enable them to produce the detailed documentation demanded of them by insurance companies quickly and with little effort.
It is a further object of the invention that the above apparatus should be highly portable allowing caregivers to carry the invention to patients.
It is a further object of the invention to provide caregivers with an apparatus to generate individualized multiple alternative Treatment Plans for each patient so that the caregiver might better define an optimal Treatment Plan.
It is further an object of the invention to construct the above apparatus so that it is adaptable to individuals and groups so that patients may be tracked through multiple therapeutic environments.
It is further an object of the invention to share, in appropriate settings where confidentiality can be protected, information with colleagues so that patient treatment may be improved and to facilitate teaching of less experienced staff.
It is further an object of the invention to construct the above apparatus so complete patient histories, including billing, are complied in a database as the caregiver uses the invention
It is further an object of the invention to format reports in such a way that patient privacy is protected while report recipients, i.e. insurance companies, receive adequate patient condition documentation.
These and further objects are attained by a computerized method and apparatus which automatedly generates various reports for a psychotherapy provider. These reports include Treatment Plans, progress reports, scheduling reports and billing reports. The progress reports include a Progress Note which incorporates various selected data into a report for the insurance company. As much of the data is selected from menus, the resulting report can maintain much patient privacy while being satisfactory to the insurance company. More private information can be stored separately in Expanded Text. A Treatment Plan is generated using the various selected data with respect to subsets of emotional factors, intellectual factors, physical factors, social factors, and spiritual factorand These subsets may be chosen randomly or with some periodic selection.
FIG. 1 shows a block diagram of the basic therapeutic process. A first step is problem identification. As might be expected, problem identification is vitally important because a misstep at this point will waste time and can even lead to an improper Treatment Plan that might not benefit the patient or could even harm the patient. Problem identification is difficult because a patient may have little or no idea of the real nature of his or her problem(s). It is up to the caregiver to accurately diagnose the true nature of the patient""s problem(s) through interaction and observation of the patient and by gathering information from collateral sources.
A next step is to make an assessment of the identified problem In assessing the problem, the caregiver will want to define the problem more concisely, try to find a precipitating event, and find out what the problem means to the patient. Throughout the problem identification and assessment steps, the caregiver will record observations about the patient, typically by taking notes on a computer, by tape recorder, dictation or by hand.
As shown in FIG. 1, a next step is to make a formal record of observations. This usually is performed after seeing a patient, and may include a reexamination of the problem identification and assessment steps. At this point, a caregiver must make a decision to continue or to end treatment. If continued treatment is indicated, the caregiver will define short-term objectives and long-term treatment goals then construct Treatment Plans to accomplish these goals.
A final step is Treatment Plan implementation. FIG. 1 shows the therapeutic process as a closed loop system with problem identification as the next step after treatment implementation. While this is a simplification, as is the whole of FIG. 1, overall it is an accurate representation of the process.
After Treatment Plan implementation, the caregiver must decide if the Treatment Plan is beneficial and should be continued, or if it should be modified or abandoned. As shown by FIG. 1, the effectiveness of the Treatment Plan is determined through repeating the process of FIG. 1.
The present invention uses portable devices such as laptop computers to streamline the caregiver""s record keeping throughout the process of FIG. 1. Additionally, the invention""s Treatment Plan generation facility acts as a panel of experts aiding the caregiver with expert advice.